Provider Demographics
NPI:1457655953
Name:ADAMO, ASHLEY DAWN (PA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:DAWN
Last Name:ADAMO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:DAWN
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3202 GREEN VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301
Mailing Address - Country:US
Mailing Address - Phone:910-892-1778
Mailing Address - Fax:
Practice Address - Street 1:1840 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-1633
Practice Address - Country:US
Practice Address - Phone:910-223-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02672363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant